Prognostic Index for Acute- and Lymphoma-Type Adult T-Cell Leukemia/Lymphoma
Prognostic Index for Acute- and Lymphoma-Type Adult T-Cell Leukemia/Lymphoma
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DOI：
10.1200/jco.2011.38.2101
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发表时间：
2012-05-10
影响因子：
45.3
通讯作者：
Tamura, Kazuo
中科院分区：
文献类型：
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作者：
Katsuya, Hiroo;Yamanaka, Takeharu;Tamura, Kazuo
目的成人急性T细胞白血病/淋巴瘤（ATL）和淋巴瘤型成人T细胞白血病/淋巴瘤（ATL）的预后较差，但其生存结局存在显著差异。本研究的目的是制定一个预后指数（PI）为急性和淋巴瘤型ATL（ATL-PI）。患者和MethodsIn一项回顾性研究，从2000年1月和2009年5月之间新诊断为急性和淋巴瘤型ATL的807例患者的数据进行了评估。我们将受试者随机分为训练（n = 404）和验证（n = 403）样本，并制定了PI使用多变量分数多项式model.ResultsMedian总生存时间（MST）为807例患者为7.7个月。在训练样本中，安阿伯分期（I和II v III和IV）、体力状态（0 - 1 v 2 - 4）和三个连续变量（年龄、血清白蛋白和可溶性白细胞介素2受体[sIL-2 R]）被确定为独立的预后因素。使用这些变量，设计了一个预后模型来确定不同的风险水平。在验证样本中，高、中和低风险患者的MST分别为3.6、7.3和16.2个月（P <0.001; chi（2）= 89.7，2 df;对数秩检验）。我们还根据年龄为70岁、血清白蛋白为3.5 g/dL和sIL-2 R为20，000 U/mL的二分法简化了原始ATL-PI，并开发了一种易于计算的具有预后判别力的PI（P <0.001）卡方检验（χ 2）= 74.2，2df;结论ATL-PI是一种有前途的新工具，用于识别不同风险的急性和淋巴瘤型ATL患者。
PurposeThe prognosis of acute- and lymphoma-type adult T-cell leukemia/lymphoma (ATL) is poor, but there is marked diversity in survival outcomes. The aim of this study was to develop a prognostic index (PI) for acute- and lymphoma-type ATL (ATL-PI).Patients and MethodsIn a retrospective review, data from 807 patients newly diagnosed with acute- and lymphoma-type ATL between January 2000 and May 2009 were evaluated. We randomly divided subjects into training (n = 404) and validation (n = 403) samples, and developed a PI using a multivariable fractional polynomial model.ResultsMedian overall survival time (MST) for the 807 patients was 7.7 months. The Ann Arbor stage (I and II v III and IV), performance status (0 to 1 v 2 to 4), and three continuous variables (age, serum albumin, and soluble interleukin-2 receptor [sIL-2R]) were identified as independent prognostic factors in the training sample. Using these variables, a prognostic model was devised to identify different levels of risk. In the validation sample, MSTs were 3.6, 7.3, and 16.2 months for patients at high, intermediate, and low risk, respectively (P < .001; chi(2) = 89.7, 2 df; log-rank test). We also simplified the original ATL-PI according to dichotomizing age at 70 years, serum albumin at 3.5 g/dL, and sIL-2R at 20,000 U/mL and developed an easily calculable PI with prognostic discrimination power (P < .001; chi(2) = 74.2, 2 df; log-rank test).ConclusionThe ATL-PI is a promising new tool for identifying patients with acute- and lymphoma-type ATL at different risks.